Ann Surg Treat Res.  2021 Nov;101(5):291-298. 10.4174/astr.2021.101.5.291.

Increased depression risk in patients with abdominal aortic aneurysm: a nationwide cohort study

• Kim Mh
• Yoo Jh
• Cho Hj
• Ko KJ
• Jun Kw
• Han Kd
• Hwang Jk

• KMID: 2521851
• DOI: http://doi.org/10.4174/astr.2021.101.5.291

Abstract

Purpose
Abdominal aortic aneurysm (AAA) is a critical disease. Most studies of AAA consider reoperation rate, complications, or mortality, but do not consider a patient’s mental state. However, there is a possibility of interaction between AAA and depression in disease development and prognosis. We investigated the incidence and risk ratio of depression in patients with AAA using nationwide data.
Methods
We selected subjects from National Health Insurance System database who were diagnosed with AAA between 2009 and 2015 and survived at least 1 year after diagnosis or AAA surgery (n = 10,373). We determined the control group using propensity score matching by age and sex. The control group had about 3 times the number of subjects as the AAA cohort (n = 31,119).
Results
The incidence of depression was 1.4 times higher in the AAA group than the control group. We further analyzed the incidence of depression in the AAA group according to treatment modalities (nonsurgical vs. surgical or nonsurgical vs. open surgical aneurysm repair vs. endovascular aneurysm repair) but found no significant difference among them. The incidence of depression was significantly higher in patients aged <65 years than in patients aged ≥65 years (hazard ratio, 1.539 vs. 1.270; P < 0.001).
Conclusion
The incidence of depression was higher in the AAA group, with an especially high risk for depression in patients aged <65 years. The psychiatric status of patients with AAA should be carefully monitored for clinicians to intervene when appropriate.

Keyword

Aortic aneurysm; Depression; Incidence; Mental disorders; Psychiatry

Figure

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  Fig. 1 Flowchart of the study population. AAA, abdominal aortic aneurysm.

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  Fig. 2 Kaplan-Meier plot of the incidence of depression. (A) The incidence of depression is increased in the abdominal aortic aneurysm (AAA) cohort with statistical significance. (B, C) There is no definite difference between non-surgery and surgery groups and among non-surgery, open surgical aneurysm repair (OSAR), and endovascular aneurysm repair (EVAR) groups.

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